dysmenorrhea

Menstruation, or period, is normal vaginal bleeding that happens as part of a woman's monthly cycle. Many women have painful periods, also called dysmenorrhea. The pain is most often menstrual cramps, which are a throbbing, cramping pain in your lower abdomen. You may also have other symptoms, such as lower back pain, nausea, diarrhea, and headaches. Period pain is not the same as premenstrual syndrome (PMS). PMS causes many different symptoms, including weight gain, bloating, irritability, and fatigue. PMS often starts one to two weeks before your period starts.

There are two types of dysmenorrhea: primary and secondary. Each type has different causes.

Primary dysmenorrhea is the most common kind of period pain. It is period pain that is not caused by another condition. The cause is usually having too many prostaglandins, which are chemicals that your uterus makes. These chemicals make the muscles of your uterus tighten and relax, and this causes the cramps.

The pain can start a day or two before your period. It normally lasts for a few days, though in some women it can last longer.

You usually first start having period pain when you are younger, just after you begin getting periods. Often, as you get older, you have less pain. The pain may also get better after you have given birth.

Secondary dysmenorrhea often starts later in life. It is caused by conditions that affect your uterus or other reproductive organs, such as endometriosis and uterine fibroids. This kind of pain often gets worse over time. It may begin before your period starts and continue after your period ends.

To help ease your period pain, you can try:

• Using a heating pad or hot water bottle on your lower abdomen
• Getting some exercise
• Taking a hot bath
• Doing relaxation techniques, including yoga and meditation

You might also try taking over-the-counter pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include ibuprofen and naproxen. Besides relieving pain, NSAIDs reduce the amount of prostaglandins that your uterus makes and lessen their effects. This helps to lessen the cramps. You can take NSAIDs when you first have symptoms, or when your period starts. You can keep taking them for a few days. You should not take NSAIDS if you have ulcers or other stomach problems, bleeding problems, or liver disease. You should also not take them if you are allergic to aspirin. Always check with your health care provider if you are not sure whether or not you should take NSAIDs.

It may also help to get enough rest and avoid using alcohol and tobacco.

For many women, some pain during your period is normal. However, you should contact your health care provider if:

• NSAIDs and self-care measures don't help, and the pain interferes with your life
• Your cramps suddenly get worse
• You are over 25 and you get severe cramps for the first time
• You have a fever with your period pain
• You have the pain even when you are not getting your period

To diagnose severe period pain, your health care provider will ask you about your medical history and do a pelvic exam. You may also have an ultrasound or other imaging test. If your health care provider thinks you have secondary dysmenorrhea, you might have laparoscopy. It is a surgery that that lets your health care provider look inside your body.

If your period pain is primary dysmenorrhea and you need medical treatment, your health care provider might suggest using hormonal birth control, such as the pill, patch, ring, or IUD. Another treatment option might be prescription pain relievers.

If you have secondary dysmenorrhea, your treatment depends upon the condition that is causing the problem. In some cases, you may need surgery.

Gonorrhea is a sexually transmitted infection (STI). It is most common in young adults. The bacteria that cause gonorrhea can infect the genital tract, mouth, or anus. You can get gonorrhea during vaginal, oral, or anal sex with an infected partner. A pregnant woman can pass it to her baby during childbirth.

Gonorrhea does not always cause symptoms. In men, gonorrhea can cause pain when urinating and discharge from the penis. If untreated, it can cause problems with the prostate and testicles.

In women, the early symptoms of gonorrhea often are mild. Later, it can cause bleeding between periods, pain when urinating, and increased discharge from the vagina. If untreated, it can lead to pelvic inflammatory disease, which causes problems with pregnancy and infertility.

Your health care provider will diagnose gonorrhea with lab tests. Treatment is with antibiotics. Treating gonorrhea is becoming more difficult because drug-resistant strains are increasing. Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading gonorrhea. If your or your partner is allergic to latex, you can use polyurethane condoms. The most reliable way to avoid infection is to not have anal, vaginal, or oral sex.

Centers for Disease Control and Prevention

Menstruation, or period, is normal vaginal bleeding that occurs as part of a woman's monthly cycle. Every month, your body prepares for pregnancy. If no pregnancy occurs, the uterus, or womb, sheds its lining. The menstrual blood is partly blood and partly tissue from inside the uterus. It passes out of the body through the vagina.

Periods usually start between age 11 and 14 and continue until menopause at about age 51. They usually last from three to five days. Besides bleeding from the vagina, you may have:

• Abdominal or pelvic cramping pain
• Lower back pain
• Bloating and sore breasts
• Food cravings
• Mood swings and irritability
• Headache and fatigue

Premenstrual syndrome, or PMS, is a group of symptoms that start before the period. It can include emotional and physical symptoms.

Consult your health care provider if you have big changes in your cycle. They may be signs of other problems that should be treated.

NIH: National Institute of Child Health and Human Development

Pain is a signal in your nervous system that something may be wrong. It is an unpleasant feeling, such as a prick, tingle, sting, burn, or ache. Pain may be sharp or dull. It may come and go, or it may be constant. You may feel pain in one area of your body, such as your back, abdomen, chest, pelvis, or you may feel pain all over.

Pain can be helpful in diagnosing a problem. If you never felt pain, you might seriously hurt yourself without knowing it, or you might not realize you have a medical problem that needs treatment.

There are two types of pain: acute and chronic. Acute pain usually comes on suddenly, because of a disease, injury, or inflammation. It can often be diagnosed and treated. It usually goes away, though sometimes it can turn into chronic pain. Chronic pain lasts for a long time, and can cause severe problems.

Pain is not always curable, but there are many ways to treat it. Treatment depends on the cause and type of pain. There are drug treatments, including pain relievers. There are also non-drug treatments, such as acupuncture, physical therapy, and sometimes surgery.

NIH: National Institute of Neurological Disorders and Stroke